The fetal/child perspective - Risks related drug exposure of the child, breastfeeding and when to reassume medication
ECTRIMS Online Library. Hellwig K. 09/11/19; 279372; 20
Kerstin Hellwig
Kerstin Hellwig
Contributions
Abstract

Abstract: 20

Type: Hot Topic

Abstract Category: Hot Topic 2: MS Pregnancy in the treatment era

K. Hellwig, DMSKW Study Group

St. Josef Hospital, Ruhr University, Bochum, Germany

Since MS affects twice as many women as men and with clinical onset often during childbearing years therefore, pregnancy counselling is an important aspect of the neurologist's daily clinical practice. Until the 80s, MS patients were discouraged from having children due to a false belief that pregnancy would worsen the disease course. A paradigm shift occurred in 1998 when the prospective Pregnancy in MS (PRIMS) study showed a reduced relapse rate during pregnancy but also an increase of the relapse risk postpartum. At the same time, the first disease-modifying drugs (DMDs) entered the market followed by many more during the last three decades. However, at the time of approval of new medication only data from reproductive toxicity animal studies and very few exposed pregnancies during clinical trials are available. It is therefore a challenge to counsel people with MS planning a pregnancy and determine the best risk benefit balance for mother and child when to stop or restart treatment. In this presentation -taking the child's perspective- an update on safety information on available immunomodulatory treatment and exposure during pregnancy and pregnancy outcomes will be presented. The best strategy postpartum is still under scientific debate. Pros and cons of breastfeeding versus postpartum treatment initiation will be discussed.
Disclosure: Kerstin Hellwig has served on scientific advisory board for Bayer, Biogen, Genzyme Sanofi, Teva, Roche, Novartis, Merck. She has received speaker honoraria and research support from Bayer, Biogen, Merck, Novartis, SanofiGenzyme, Teva and has received support for congress participation from Bayer, Biogen, Genzyme, Teva, Roche and Merck.

Abstract: 20

Type: Hot Topic

Abstract Category: Hot Topic 2: MS Pregnancy in the treatment era

K. Hellwig, DMSKW Study Group

St. Josef Hospital, Ruhr University, Bochum, Germany

Since MS affects twice as many women as men and with clinical onset often during childbearing years therefore, pregnancy counselling is an important aspect of the neurologist's daily clinical practice. Until the 80s, MS patients were discouraged from having children due to a false belief that pregnancy would worsen the disease course. A paradigm shift occurred in 1998 when the prospective Pregnancy in MS (PRIMS) study showed a reduced relapse rate during pregnancy but also an increase of the relapse risk postpartum. At the same time, the first disease-modifying drugs (DMDs) entered the market followed by many more during the last three decades. However, at the time of approval of new medication only data from reproductive toxicity animal studies and very few exposed pregnancies during clinical trials are available. It is therefore a challenge to counsel people with MS planning a pregnancy and determine the best risk benefit balance for mother and child when to stop or restart treatment. In this presentation -taking the child's perspective- an update on safety information on available immunomodulatory treatment and exposure during pregnancy and pregnancy outcomes will be presented. The best strategy postpartum is still under scientific debate. Pros and cons of breastfeeding versus postpartum treatment initiation will be discussed.
Disclosure: Kerstin Hellwig has served on scientific advisory board for Bayer, Biogen, Genzyme Sanofi, Teva, Roche, Novartis, Merck. She has received speaker honoraria and research support from Bayer, Biogen, Merck, Novartis, SanofiGenzyme, Teva and has received support for congress participation from Bayer, Biogen, Genzyme, Teva, Roche and Merck.

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